Standing Committee B

[Mr. Win Griffiths in the Chair]

Health (Wales) Bill

Schedule 1 - Schedule 7A to be inserted in the National Health Service Act 1977

Chris Grayling: I beg to move amendment No. 17, in
schedule 1, page 6, leave out lines 13 and 14.

Win Griffiths: With this it will be convenient to take New Clause 1—Composition of Community Health Councils—
'The membership of Community Health Councils shall be constituted as follows— 
 (a) one-half of the members shall be nominated by the local authorities within the area of the Community Health Council's operations; 
 (b) one-third of the members shall be nominated by those voluntary organisations active within the area of the Community Health Council's operations; and 
 (c) the remainder of the members shall be nominated by the National Assembly for Wales.'

Chris Grayling: I welcome you back to the Chair, Mr. Griffiths. It is a gloomier evening than one might choose.
 The amendment and new clause are designed to follow the theme that Opposition Members have pursued throughout the debate so far, which is to try to provide an appropriate balance between the interests of the Welsh Assembly and its role as manager of the Welsh national health service and the need for independent scrutiny of the performance of the Welsh NHS in the hands of communities and professionals and not just politicians. They are part of the jigsaw puzzle of various ideas that I described to the Minister this morning, which we proposed to reflect our concerns and to amend the Bill. 
 I know that the Minister will say that Opposition Members do not understand devolution or the need to push powers down to the Assembly. In fact, I understand perfectly well the principles of devolution and where it is right to give powers to the Assembly. The Bill grants powers to the Assembly entirely appropriately at many points, but as the debate unfolds, the Minister will understand that we are keen to ensure that there is a balance and that we do not simply hand over to the Assembly—lock, stock and barrel—the right to monitor the performance of the NHS in Wales. 
 Ultimately, the power to monitor should not be controlled by the same organisation that delivers the strategy and, to a significant degree, the overall management of the service. It is essential to maintain the genuine independence of the community health councils, which the amendment and new clause would ensure. I hope that the Minister will recognise that, 
 and consider the amendment and the new clause in the spirit in which they have been tabled. 
 Nominations for membership of CHCs come from three, and often four, separate groups: the local authority; voluntary organisations in the areas served by the CHC; the National Assembly; and, in some cases, co-optees, to represent different parts of the local community that do not fit the formula. That structure provides an excellent balance. It was set up by past legislation, and I can see no good reason why it should change. It may not be the National Assembly's intention to change it, but politicians have a habit of placing their cronies in organisations. All parties have been guilty of that to some degree, but despite its initial public statements, the Labour party has been especially bad in terms of placing people in jobs, especially in recent years. It is important to ensure that no process enables the Assembly simply to control the choice of people who sit on the CHCs. What we have already works.

Huw Edwards: The hon. Gentleman claimed that things had got worse under the Government. Does he agree that, under the Government, all quango appointments in the National Assembly must be advertised, and that there is open competition?

Chris Grayling: The hon. Gentleman will find, if he looks across the United Kingdom—including Wales—that there have been significant numbers of appointments to key jobs of people with political links. Even if those jobs are advertised openly, as all such jobs are, that does not necessarily mean that the end appointment is free from political influence. [Interruption.] I will happily stand by that comments. Simply having a process in which a job is advertised does not remove the likelihood and risk of a political appointment.
 Our proposals would at least spread out responsibility for nominations to the bodies, and would ensure a truly representative mix of people on those bodies. I do not cast aspersions on the current Administration in Wales. However, by allowing what happens at present to continue, we give current and future politicians the opportunity to shape the membership of those bodies. We should not do that.

Julie Morgan: Does the hon. Gentleman believe that the presently constituted community health councils, admirable as they are, fully represent the range of people and interests in Wales?

Chris Grayling: I thank the hon. Lady for her intervention, as I was coming on to consider a few such examples. For instance, Meirionnydd community health council has a good mix of people and organisations represented on it, such as the local Red Cross, the Wales Council for the Deaf and the Multiple Sclerosis Society. A number of local authority members are on the board of the community health council, and there are representatives of the Stroke Association and the First Minister. The local authority members on the body are spread quite widely across the area. That collection of organisations represents different patient
 groups that use the national health service. Different communities are represented through their elected representatives and there is a representative of the First Minister of the National Assembly. That is an eminently sensible mix of people to serve as patient representatives on the community health council for the area.

Julie Morgan: One of the key questions to consider in setting up and strengthening the new community health councils is how to make them representative in a way that has not always been possible. For example, does the hon. Gentleman know whether the representatives from the Stroke Association or the Multiple Sclerosis Society have experienced the disease themselves, or are they carers? Representation of people with such experience—rather than professionals and societies, admirable as their contributions may be—is a key issue in terms of getting genuine representation on bodies such as community health councils.

Chris Grayling: I hear what the hon. Lady says. In my experience—and, I am sure, in hers as well—the people who tend to be most active in voluntary groups of local representatives of those organisations have been motivated to join by their or their families' experience. I am comfortable, in so far as it is possible, that on a local basis those organisations provide good representation of the community interest and the patient interest.

Hywel Williams: The Rowntree Foundation carried out research—some of it in Powys—into the National Health Service and Community Care Act 1990. It identified the problem that in rural areas there is a limited pool of potential members, and that we must have a more active policy of involving people who are excluded—those who are not members of voluntary organisations, admirable as those organisations are. That includes the rural poor and the rural disenfranchised.

Chris Grayling: I entirely agree with the hon. Gentleman, but he highlights a problem that exists for the voluntary organisations. I should be surprised if any voluntary organisation in his constituency said that it had enough people. Not enough people are willing to get involved, and anything that we can do to encourage people to participate—either directly or through voluntary organisations—is entirely to be welcomed, and I fully accept the problems that have been highlighted.

Nigel Evans: Surely new clause 1 takes care of that in any event, and does not prescribe the exact membership of those bodies. I fully accept what the hon. Members for Cardiff, North (Julie Morgan) and for Monmouth (Mr. Edwards) said; they intimated that we should have as wide a representation as possible. However, we are considering nomination powers. There is nothing to stop the Assembly, the local community health councils or the voluntary sector nominating some of the people who fall within the wide remit that they mentioned.

Chris Grayling: Indeed, I agree with my hon. Friend. The purpose of the two new clauses is to ensure that the framing of the groups of people to be represented on those bodies should not be merely a matter of political debate in the Assembly. We already have a framework in place for the membership of community health councils.
 I have been looking at the membership of the councils; not only do they have a diverse membership, it is clear that that membership covers a wide range of community representation. It may not be as diverse as we would wish in some rural areas, but that problem is found not only in community health councils. Nevertheless, each council makes it clear that it has a group of people who are representative of the community. For instance, the Vale of Glamorgan has a membership of 20, plus two co-opted members; 10 are appointed by the local authority, eight by voluntary organisations, two by the National Assembly for Wales and two are co-opted. The co-opting of members permits the addition of one or two people of the kind described. However, there is no reason why voluntary organisations should not appoint patient representatives or carers of those in difficulties. 
 We argue that the appointment process should not be handed over to the organisation that runs the service. We already have a legal framework in place that sets the parameters outlined in new clause 1, and it works; it gets a good mix of people on to the councils. We do not want to see the power to change that framework placed in the hands of the organisation that those people should be scrutinising. That is the key point. 
 It is not that the Assembly should not have the power to take such decisions; of course it should. If the Assembly is to exist, it clearly needs the power to take those decisions. We argue that there is a conflict of interest; the organisation that runs the service—it takes decisions about the way in which health care operates in Wales, and is accountable for the performance of that service—should not have overall responsibility for establishing the appointment process of the council membership. 
 I go back to what I said to the Minister this morning. It is not simply a question of what the current Administration what might do or what is happening today. None of us has a crystal ball; none of us knows what political shape the Assembly might take in future, what political motivation it might have or how it might seek to change the public appointment process to serve its own ends. Surely, we should retain a framework in primary legislation that establishes the kind of people who should serve on community health councils. 
 We are happy to hear the Minister's ideas if he believes that the framework that we have put forward is wrong. He may say that we should do it differently. He may suggest that we should set aside 10 per cent. for patients, or 5 per cent. for carers. He may suggest setting aside a proportion of the membership for serving health professionals in the region concerned. Those might be perfectly coherent ways of approaching the problem, but we adopted the 
 current framework because there was no evidence to suggest that the system was not working or not delivering. Members of the councils do the job properly and provide effective scrutiny of the national health service in Wales, as others have done previously in the whole of the United Kingdom. However, if the Minister says that he accepts the principle but that it will be achieved in a different way, we will look favourably upon any Government amendment. 
 The principle is that the National Assembly should not be allowed to be both poacher and gamekeeper. We must not allow politicians control over those whose job it is to scrutinise the performance of the services that they run. I hope that the Minister will think that through and ensure that it is reflected in this measure and in others that are designed to strengthen the Bill, to enhance its quality and to make the organisations more effective. The independence of the CHCs will be strengthened by some of our amendments. I hope that he can accept this amendment in the spirit in which it is proposed.

Don Touhig: All of us want to maintain the independence of CHCs. It is essential to the work that they do that they should be seen to be, as far as possible, at arm's length in terms of their scrutiny and support for the health service. I do not dismiss the Opposition's amendments or the new clause because they have got it wrong; rather, I do not believe that they provide the right track to follow to achieve independence.
 Amendment No. 17 would prevent the Assembly from making regulations about the membership of CHCs and would restrict the Assembly in its intention to move gradually to more open membership of CHCs. Those aims are strongly supported by CHCs in Wales, who have pressed for a more open approach to appointments to CHCs. The removal of the sub-paragraph specified in the amendment would prevent the Assembly from securing incremental change in membership to better reflect the needs and aspirations of local communities. That is what the Bill seeks to do. 
 It is important for the membership of a CHC to reflect the community that it serves; many local authority and voluntary sector members have made a tremendous contribution over the years. I witnessed that when I was a local authority member and the hon. Member for Epsom and Ewell (Chris Grayling) reflected it when he referred to Meirionnydd. They play an important role in CHCs. It would be wrong to lose them—we want to retain their expertise, their background and their knowledge. I assure hon. Members that the Assembly is not seeking to control CHC membership. Because it wants to retain as many such people—where appropriate—as possible, it seeks to move to a more open method of recruitment in order to ensure that the members of CHCs fully represent their communities. He is right that CHC membership is now made up of one half local authority nominations, one third the voluntary sector and the remainder Assembly appointees. 
 Recruitment of Assembly-nominated members is set out in accordance with the Assembly's published code of practice for ministerial appointments to public bodies. Vacancies are advertised in the media, both locally and nationally. Applicants are interviewed by the Assembly's public appointments branch in accordance with the Nolan principles. It is easy to score party political points, but I am sure that the hon. Member for Epsom and Ewell will agree that that is the right way to do things, rather than to continue as we did in the past, when many appointments were made exclusively by Ministers without any consultation and without the open application that is now preferred by the National Assembly for Wales.

Nigel Evans: Would not it be better for other bodies to have an input in nominating their own people to CHCs, taking some of the power away from the Assembly? Let us consider the worst-case scenario suggested by my hon. Friend the Member for Epsom and Ewell. If the Assembly were controlled by a group of people whom we cannot even envisage at this time, they might try to load CHCs with people from the same mould as themselves. Would not it be far better for other people to have an input into the composition of CHCs?

Don Touhig: I understand the thrust of what the hon. Gentleman says, but surely nomination could be seen as more susceptible to cronyism if we reserved half the membership of CHCs for local authorities, as is currently the case.
 Let me explain why I resist new clause 1. Earlier, the Opposition made a number of perfectly valid points about the desirability of removing control of the bodies from politicians; yet the new clause proposes that elected local politicians should retain power. It would reserve for them half the nominations and therefore half the membership of CHCs. Surely that goes against the grain of what the hon. Member for Epsom and Ewell and his colleagues said earlier. 
 New clause 1 would restrict the Assembly's intention to move forward to a more open membership, which CHCs themselves have been advocating. It would secure a place on CHCs for local politicians with no scrutiny other than the fact that their local authority nominated them and it was Joe Bloggs' turn, or the turn of someone from another party. That would not be as open, transparent and testing as the method that the Assembly is using of application, interview and appointment.

Chris Grayling: The point about elected local authority representatives is that it is important to secure community representation. I gave the example of Meirionnydd, where there is representation from a number of towns. The local authority route provides a vehicle to ensure balanced representation from the area covered by a CHC. If that is part of the mix, along with people who represent patients' groups and others from the community, it is in no way an invalid approach.

Don Touhig: Having known local authority representatives over the years, as I am sure the hon. Gentleman has, I accept that many of them have made an important contribution to the work of CHCs.
 However, we are trying to move to a system in Wales in which more people from across the board and with or without political links can apply to serve on CHCs. That approach may not be recognised, appreciated or valued in other parts of the United Kingdom. The people will be properly interviewed and a proper appointment made, taking into account what they can contribute as individuals, not the fact that there is a block number of places left on the CHC for the voluntary sector or local authorities.
 Placing a membership requirement in the Bill would prevent the incremental change that my colleagues in the Assembly seek. We can even argue that the hon. Gentleman's proposal is virtually unworkable, because although it requires a third of the members to be nominated by voluntary organisations that are ''active'' in the area of the CHC, the word ''active'' is not defined. In those circumstances, an organisation could meet—[Interruption.] It is not up to me to define the word ''active'' or the value or importance of it; it is up to the Opposition, who tabled the new clause. 
 An organisation that meets in an area might not do terribly much, but it might be said to be ''active'' and could therefore nominate people to serve on CHCs. It is important that the membership of CHCs truly reflects the communities that they serve. Many local authority and voluntary sector groups make an important contribution, which we do not want to lose, but it is important that we open up the opportunities for more people to serve on CHCs. The Assembly's approach of an incremental move to public advertisement, interview and appointment is right. I could say more, but given those remarks, I hope that the hon. Gentleman will reflect on his proposals in amendment No. 17 and new clause 1. We share the same objective, but his solution is more restrictive and prescriptive; it would not allow people to serve on community health councils unless they came from the voluntary sector or the local authority sector. That restricts the opportunity for people in communities to play an important part. 
 I hope that the changes brought about by the National Health Service Reform and Health Care Professions Bill will mean that when the 22 local health boards take over, decisions about who is to control spending and determine the priorities will be pushed down to be taken by local people, who will consider the needs, aspirations and hopes of their communities. Appointments to the community health councils will open things up and give more people, regardless of their party political affiliation or lack of it, the opportunity to take part in the scrutiny of the national health service and to make an important contribution to the way the health service is run.

Roger Williams: I agree with those who have spoken in the debate; we are all in favour of having a broader representation on community health councils and a more open way of appointing the members. That will ensure that they reflect the nature and composition of the area they represent in considering the quality of the health service that is provided for local people.
 The hon. Member for Epsom and Ewell seems to be embracing the concept of devolution but he has not got there yet. Glyn Davies, the Assembly Member for Mid and West Wales, has been referred to. He said: 
''I would like to see more Conservative ideas about how we can improve devolved Government and less looking back towards a more centrally based system of government.''
 As those of us who know Glyn are aware, he is not in the best of health, but his ideas are fairly robust. 
 The amendment would mean that the powers were held centrally, in Westminster. But we should have the faith and confidence to say that these matters should be for regulation by the Assembly. I do not go along with the argument that things are hunky dory at the moment. Recently, I received a letter from a person who has reservations about the Bill, stating: 
''Roughly six months ago I had reason to go to my GP's surgery. On one of the notice boards was a list of members of the local CHC with the area they represent . . . we established the political affiliation of the twelve members of this CHC. They were either serving Labour Councillors, former Labour Councillors or, yes you've guessed it, members of the local Labour party.''
 I have not said which local CHC the letter referred to because I have not been able to ascertain whether the statement is truthful, but that is people's perception. We must break away from that.

Chris Grayling: The hon. Gentleman must remember that the local authorities are under a statutory duty to allocate places on internal and external bodies in proportion to the membership of their authority. It is possible, although undoubtedly regrettable, that the authority concerned may have been made up entirely of Labour members. If that is the case, it is a disservice to the community but probably not against the law.

Roger Williams: The hon. Gentleman makes a point about proportional voting for local government, because several local authorities are entirely composed of one party.
 We must have courage, and confidence in the Assembly, which would like a much fairer and more open way of appointing people to CHCs. On Second Reading, I said that several local authority members have served with great distinction on CHCs and have given a huge amount of time and effort to ensure that those councils are effective. At the same time, there is a perception that certain local authority members see the membership of the CHC as an adjunct to their local authority work and do not have the time, and cannot make the effort, to make it work and to put in their full whack. 
 We could consider having fewer local authority members on CHCs because, after April, there will be four local authority representatives on the local health board, too. Most of those local health boards will commission health care but some—particularly the one in Powys, which will take the place of not only the health authority but the trust—will deliver health care, too, such as out-of-hours services for GPs. If local authority people are almost in the majority on the CHCs and there are local authority people on the local health boards, there could be a conflict of interest. 
 I have confidence that the Assembly will be much more open about this matter. It may take specific measures to include young people, people from ethnic minorities and disabled people and will use the Nolan principles to make the appointments. The amendment does not accord with the Rawlings principles of how legislation should be drafted to ensure that devolution works and to give discretion to the National Assembly for Wales.

Jon Owen Jones: Does the hon. Gentleman believe that having a large representation of local authority members on both CHCs and health boards will, of itself, ensure that the bed blocking problem in Wales can be dealt with without recourse to fining local authorities?

Roger Williams: Having local authority members on the local health boards will mean that there is some co-ordination between social services and the NHS and so will help to eliminate bed blocking. I do not think that having local authority members on the CHC will contribute to the resolution of that problem.

Julie Morgan: I support what the Minister and the hon. Member for Brecon and Radnorshire (Mr. Williams) have said about moving away from party political patronage. It is essential that we move to a more open, Nolan-style, method of appointment. The move to advertise appointments on public bodies is a tremendous advance. It will open up public bodies to the public, rather than to a narrow range of elected people who then appoint people like themselves. The amendment would take us back to the pre-Nolan era. I hope that the hon. Member will think about this amendment before he considers whether to push it to the vote.

Chris Grayling: Given that we are advocating the status quo, rather than a different approach, can the hon. Lady explain how the work done by the CHCs is disadvantaged by the present structure?

Julie Morgan: I do not wish to denigrate the work done by the CHCs. They do a very good job. However, they could do a much better job. Having their membership selected by open advertisement will bring people on to them who are not local authority members, or members of the Labour, Conservative, or Liberal Democrat parties, or of Plaid Cymru. They will want to be on the CHC and will be prepared to go through the arduous process of responding to advertisements, being interviewed and being appointed. As I understand it, the Assembly appointments are made on a cross-party basis. There is no political patronage in the final appointments to public bodies in Wales.
 We should certainly embrace that message on the appointment of CHCs and bring in an open method of advertising. We should not think, however, that people will flock in if we simply advertise. We must make a huge effort to place advertisements where people will see them. As the hon. Member for Brecon and Radnorshire said, black people and young people are under-represented on CHCs. To encourage members from under-represented groups to apply, we must 
 ensure that advertisements reach them. We must also make every effort to show that they would be welcome on CHCs. The ultimate decision is based on carefully thought out principles of appointment, but it is hard to get members of under-represented groups as far as the final selection process. However, the present proposals are the best means we have of doing that, and we will certainly not overcome under-representation using the methods that the Opposition recommend for appointing people. They have not resulted in representative CHCs, so it is important that we resist the amendment, and go down the open Nolan way of appointing people.

Hywel Williams: I am slightly unclear about the intention of the hon. Member for Epsom and Ewell in tabling the amendment. I thought that he was edging towards advocating apolitical, rather than independent members. Apolitical members are a bit like the unicorn: they are free, wild and beautiful, but essentially mythical. We are looking for independent members. We all have our own views, and joiners tend to join because they have their own views. The trick is properly to regulate those views and ensure that people take an independent stance. The way to do that is to have the very highest standards in public life, and we have taken many large strides in that direction in the past few years.
 We must also ensure that members consult and represent their communities more effectively, but that is difficult. The communities first programme has operated in my constituency, and people who would never have taken part in public life have been enabled to join; they might now respond to an advertisement. Getting to that point is quite a task; it is a process, rather than a matter of taking snapshots of the community and selecting prominent people. I fear that setting proportions of people to be nominated for CHCs by other bodies will not achieve our aim.

Chris Grayling: Let me deal with one or two of the points that have been raised. The hon. Member for Cardiff, North talked about the need to progress down the open process route that she described. With respect, however, we are not doing that. We are framing a power that would enable the Assembly to go down that route, and it may indeed choose to do so. Equally, however, it would have the power to make entirely political appointments from its own ranks, should it choose to do so. We are talking not about the nature of the process that the Assembly intends to go through but about framing certain safeguards in law to ensure that bodies have the power to remain in perpetuity independent of the administration of the national health service in Wales.

Julie Morgan: The amendment goes directly against the principles of openness. Does that not contradict what the hon. Gentleman has just said?

Chris Grayling: Let me return to that point in a moment, because I have a thought for the hon. Lady and the Minister. First, I wish to make one or two other points. The Minister referred to the definition of being active in a local area, and organisations may be active to a greater or lesser degree. That is right, but it applies to virtually everyone who is a representative on a CHC. Any organisation that any of us has been
 involved with includes some people who are hard working and others who turn up only for an occasional meeting. Nothing that we as legislators—or the Assembly in Cardiff—do will ever change that. The reality is that people who give up time to attend meetings to represent their organisations—whether a local authority, patient group or other community organisation—will do so because they want to play an active role.

Don Touhig: I refer the hon. Gentleman to new clause 1(b):
''one-third of the members shall be nominated by those voluntary organisations active within the area of the Community Health Council's operations''.
 We must define ''active''. Otherwise, even if it were not doing much in the community, any organisation could claim that it had the right to be present and to nominate people to CHCs. It is bad drafting on the part of the Opposition.

Chris Grayling: I shall be happy to listen to the advice of Government draftsmen if the Minister accepts the principle of the amendment. The word ''active'' is fairly comprehensible to most of us; if it needs to be made more legalistic, I shall be delighted to hear the Government's proposals.
 The hon. Member for Brecon and Radnorshire, who continues to take advantage of the article in the paper this morning and to revert to the devolution issue, still misses the point. We are not arguing about devolution: we all accept that the NHS in Wales has responsibility for running the NHS in Wales. As legislators, and under our constitution, we have responsibility for primary legislation across England and Wales, so it is important to provide a balance between those holding political and administrative responsibility for the NHS and those with the remit to scrutinise the performance of people in that role. It is not entering a debate on the rights and wrongs of devolution to argue that those responsibilities should be separated, as far as possible, to ensure that scrutiny is genuinely independent and not potentially influenced by party politics or politicians.

Roger Williams: I would accept that if the Assembly were to use its powers directly to appoint people, but it has adopted the Nolan principle of open selection for public bodies. Does that not overcome the hon. Gentleman's reservations and concerns?

Chris Grayling: Surely the hon. Gentleman accepts that the role of legislators is to provide a framework for the future that deals with all political eventualities. It is easy to say, ''In today's world, that won't happen, so let's not bother about it'', but we can never anticipate what will happen in the future. The role of legislators is, ideally, to frame provisions that cannot be abused later. That is the reason for having checks and balances in our legislative framework that last for the duration, not just the short term. [Interruption.]

Win Griffiths: Order. When members of the Committee are speaking, they should address the Chair. Furthermore, I remind hon. Members of the
 more technical reason for facing the right way—so that the microphones pick up all that is said.

Chris Grayling: Thank you, Mr. Griffiths, and I apologise for facing the other way.

Win Griffiths: I realise that the temptation is great.

Chris Grayling: I return briefly to the intervention made by the hon. Member for Monmouth, who raised an important point about what decisions the Welsh Assembly might be free to take. It is not a Wales-only issue because CHCs have the power to scrutinise services across the border in England. I refer to the current work of the Association of Welsh Community Health Councils, which is
''voicing concerns about the English NHS plan which is weakening the strength of the patient voice in the NHS, and . . . will affect all Welsh patients who receive health services in England''.
 The implications of our decisions about the powers of the Assembly are not exclusively Welsh. It may not be a major issue, but we should reflect on it. 
 I would prefer not to press the issue to a vote, although I am prepared to do so. I accept that some hon. Members will feel that our proposed framework is too rigid. Nevertheless, we stand by the principle that we should set guidelines to prevent the Assembly from taking any power that it wishes with regard to appointments. It might do so by specifying a minimum representation from patient groups, from local authorities and from other groups within the community—we do not want to prescribe exactly how things are done; it is not a question of percentages. However, in order to ensure that the checks and balances that I have described exist, minimum parameters should be set in the legislation. It should state that there must be representatives from local authorities and local groups. If the Minister will accept the principle and will agree to consider whether that element of the Bill can be strengthened in order to ensure that that safeguard exists, we shall be happy to withdraw the amendment. Will he do that?

Don Touhig: I would, but for the fact that the proposals that I have articulated today are supported by the CHCs themselves. They are urging the Assembly to introduce open recruitment. The Government and the Assembly are responding to the requirements of those who run CHCs in Wales.
 The Assembly's recruitment process is published, it is subject to a code of practice and it is open, and the Assembly, as a body corporate, has approved the code. The Opposition are right to express fears that, at some time, a different political party might try to change the code for party political ends. However, it would have to put the issue to a vote in the Assembly before a change could be made. I reassure the hon. Gentleman that there is an open and transparent system for recruiting people to serve on CHCs. The Bill seeks to extend that, not to diminish the important roles of the voluntary sector and local authorities. We are responding to a demand from CHCs in Wales, which favour a more open recruitment process. 
 I do not know what more I can say to satisfy the hon. Gentleman, other than to make it absolutely clear 
 that we are committed to the process; it is there for everybody to see. Nothing is hidden and anyone can apply. People in my community have asked how they might apply and I have given them the forms and paperwork to send in. When I attend meetings in my constituency, I ask for a show of hands to indicate who serves on the CHC. If no hands go up, I ask people to serve and invite them to apply; I tell them that we need people like them, representing all parts of the community, to participate. That is the process that the Assembly is promoting. I urge the hon. Gentleman to reflect and to withdraw the amendment and new clause 1, and to accept my assurance that the CHC movement throughout Wales supports the increasingly open and transparent recruitment process.

Chris Grayling: I have listened carefully to the Minister. I know that he is a man of principle and I accept his word. Will he at least bear in mind the concerns that have been raised? I know that further steps are to be taken in the establishment of the bodies and I hope that he and his Department will be watchful to ensure that the recruitment process, as it evolves, provides genuine independence. Accepting his word that he is mindful of that, I am happy to beg to ask leave to withdraw the amendment.
 Amendment, by leave, withdrawn. 
 Schedule 1 ordered to stand part of the Bill.

Clause 2 - Wales Centre for Health

Nigel Evans: I beg to move amendment No. 8, in
clause 2, page 2, line 12, at end insert '; but at least one-third of the members shall be appointed only on the nomination of community health councils.'.
 I welcome the hon. Member for Caernarfon back to the Committee after the strains and tortures of finding a dentist who was prepared to deal with him. I hope that he is in much better shape now than he was a few hours ago. 
 The clause and the amendment deal with the Wales Centre for Health, a body that we all welcome. It could be vital in promoting activities to protect and improve health in Wales, and will also be known as Canolfan Iechyd Cymru. I see it as an important body, which is why we seek to amend the Bill in such a way. I should be interested to hear what the Minister has to say on our suggestion, which tries to ensure some independence for the body, and with good reason. 
 Subsection (2) states: 
''The Centre is to consist of such number of members appointed by the National Assembly for Wales as the Assembly may determine''.
 That is an extremely wide power, and lets the Assembly appoint exactly whom it likes. The nomination powers may be the same as those that we spoke about on the previous amendment. The Assembly will be able to appoint the chairman or propose further regulations as to how he may be appointed. 
 One reason why we seek more certainty of independence for a body that champions patients' rights is that it will deal with some important aspects 
 of health promotion and protection. Prevention of smoking in public places was mentioned on Second Reading. Perhaps the centre will recommend policy guidance on that on behalf of the Welsh Assembly, or on behalf of us in Westminster if we want to take primary powers to try to improve health. Smoking raises the emotions of many people in one way or another, but the subject is controversial. 
 The body may deal with substance abuse as well, a vital subject that is sometimes overlooked. Ten years ago, I was extremely concerned about glue sniffing, as it was then known. Substance abuse still goes on, involving glue and other substances, and some direction is needed on it. Alcohol abuse is widely recognised in the House; the all-party group on alcohol misuse has an important role in bringing those problems to the fore. CHCs may want to carry out a study so as to start a campaign to promote sensible policy guidance on the subject. 
 I am a former chairman of the all-party group on drugs misuse, and there may be a campaign on drugs. I would welcome that in the whole community in Wales, especially schools and youth centres. I was saddened to read today that nine pupils had been suspended from a north Wales secondary school after they were allegedly caught with cannabis. The school is in Denbighshire, and the pupils have been suspended for up to 10 days. Disturbingly, the report on the matter stated that it would be the fifth time in 2002 that pupils at schools in north and mid-Wales had been disciplined over drugs. 
 That must concern all members of the Committee. We must put the message across, whether in relation to cannabis or other drugs, and we must deal with the problems that young people face. We would all welcome a campaign in schools led by the Wales Centre for Health. Again, there are resource implications, but the money would be saved in spades.

Jon Owen Jones: On a point of order, Mr. Griffiths. Is it in order for the hon. Gentleman to make a speech on a wide variety of drugs without declaring an interest as owner of a tobacconist shop?

Win Griffiths: I call the hon. Member for Ribble Valley to declare his interest.

Nigel Evans: The interest is in the Register of Members' Interests for everyone to see.

Win Griffiths: The hon. Gentleman does not sell cannabis.

Nigel Evans: Not to my knowledge, Mr. Griffiths. I suspect that the profits would not be as dire if we did, but I would not recommend that policy for our humble newsagent's shop. We do, however, sell cigarettes, which I sometimes find awkward, as, I suspect, do the tobacco companies because I recommend that people give up smoking. Any campaign that we can encourage in that regard must be welcomed.
 The Wales Centre for Health will have much work on its hands. There will be many campaigns. The Assembly will have powers to recommend that the centre examines certain key areas. No doubt, some hon. Members will write to the centre to highlight their areas of concern. As we know, there is the problem of 
 crime and drugs, not just youth and drugs. Three quarters of crime is drug-related, and if we can tackle the one, surely we can tackle the other. On a more positive note, the centre may want to campaign on healthy lifestyles and on gaining fitness through taking more exercise, such as walking instead of taking the bus or driving the car. We tabled the amendment with the aim of ensuring an independent element within that body. 
 My hon. Friend the Member for Epsom and Ewell referred to active voluntary groups. They should be allowed to be independent so that they can act on behalf of patients and see at first hand some of the problems with which the health service is faced. I am not sure how active those active groups are, or whether they have one person who is a champion for a particular cause. All hon. Members know people who fall into that category and who write to us regularly. Where would we be without them? Where would we be without the organisations that draw from a much wider pool of people; people who meet regularly to discuss issues such as the Red Cross, death, multiple sclerosis, strokes, or ME, which was commonly referred to as ''yuppie flu''? I suspect that all hon. Members have received letters from people who want the Government to do more about ME, and who doubtless want the Welsh Assembly to recognise it as a real illness, which I do, as well as to place greater emphasis on securing more consultants and specialists to deal with it. 
 The Assembly may not be so keen to concentrate on one area because of the resource implications. A group of people with their own nominees on CHCs may push the centre to consider key conditions that may not be as high profile as others. People with such conditions should not be denied access to the research that the centre will promote. I hope that when the centre is created, several of its reports will be made as widely available as possible on the internet and elsewhere. 
 We tabled the amendment because, under the schedule, the Assembly has the powers to appoint anyone to this particular body, to determine how the chairman may be appointed or even to appoint the chairman itself. That gives me cause for concern. The centre could be extremely effective in helping to promote good health in Wales and to prevent illness if it can do its job in the most effective way. I hope that the Committee will accept that there should be an element of independence within that body. I hope that we can gain some support for our amendment.

Don Touhig: We have decided that Wales needs an independent body that can provide information and impartial advice on public health issues. There is currently no equivalent body that can provide such independent advice. The status of the Wales Centre for Health will enable it to draw on academic and public sector expertise and different public and professional interests to work together. It will also support professional training in public health, including joint training between different sectors and professional disciplines.
 The Assembly has identified the need for a body with suitable standing and expertise, which can act as an advocate for public health at the national level. That has been the aim of health policy in Wales since the issue of ''Better Health, Better Wales'' in 1998. The centre will play an important role in advising the Assembly, as well as public agencies and voluntary organisations. The statutory basis for the Wales Centre for Health will ensure its legal independence and establish its role as an impartial advocate for public health in partnership with all sectors. The restructuring of the NHS underlines the relevance and importance of the part that the centre will play in addressing the long-standing legacy of ill health in Wales. The centre will be a health service body. It will not be a servant or agent of the Crown or the National Assembly for Wales. It will function at local, regional, all-Wales, United Kingdom and international levels. That is the ambition and status we have in mind for it. 
 The amendment would provide that a number of places would be reserved on this body for nominees of community health councils. Like the previous amendment, it reserves a block of places for a group, which is contrary to the way in which we are trying to develop the openness of the health service in Wales. The amendment would reduce the ability of the Assembly to determine the overall composition and balance of membership of the centre. It is the Assembly's intention that members of the centre should be appointed for their expertise and experience. Surely that ought to be the only criterion. They should be drawn from the statutory, voluntary and academic centres.

Chris Grayling: One of the great tensions within the NHS at the moment is between the academic view at the centre and the practical needs of communities. An awful lot of major health care issues are being significantly shaped by the royal colleges' textbooks—by the leading members of the profession—without reference to the implications of those decisions for the delivery of local services. Does the Minister not think that having a balance between that top level, with its undoubted expertise, and representatives of the services on the ground would provide an effective means of reconciling those different demands?

Don Touhig: The hon. Gentleman makes a fair point. We want the Wales Centre for Health to be as broadly based as possible, but to draw on all possible expertise. I am reluctant to start reserving blocks of places for groups, whether they are broadly described as having some sort of vested interest, albeit an admirable interest so far as CHCs are concerned.

Roger Williams: Will the Minister explain the role of the centre on a UK and international basis? I understand that it may provide information and knowledge that would helpful to Wales, but does he expect that it will disseminate knowledge on a greater basis than just throughout Wales?

Don Touhig: The work of the centre will be posted on its website, so there will be access across the planet to the work and research that it is doing. We need
 hope, aspiration and vision that the centre will make a wide contribution across a whole range of issues. The hon. Member for Ribble Valley (Mr. Evans) and my hon. Friend the Member for Cardiff, North spoke of AIDS and so on, and the centre may well do some work on that problem. I do have that hope and ambition for it.
 I remind Opposition Members that we undertook extensive public scrutiny on the Bill before we bringing it forward. That does not take away from hon. Members the right to seek to amend it in Committee, but no one who was consulted asked that a block of places should be reserved for a particular group. 
 Wales Centre for Health members will be recruited by the same process—and under the Nolan principles—that apply to the community health councils, and the process will be open, transparent and accountable. Nothing will be hidden. As part of the recruitment drive, people will be able to look on the Assembly website for guidance on how to become members of the Wales Centre for Health. It is important that we should make the process open, transparent and accessible, so that everyone who feels that they can make a contribution can apply. However, we want to take the proposal forward without setting a number of places aside for a particular group or any vested interest group. We think that that is the best way to push it forward. I hope that the hon. Gentleman will consider withdrawing the amendment.

Nigel Evans: I share with the Minister the same hopes and aspirations for the Wales Centre for Health. The hon. Member for Brecon and Radnorshire asked whether it was intended that the centre should consult with other UK bodies, or even more widely. I am reassured to hear that part of its research, perhaps into AIDS, will not be a Wales-only thing, or even a UK-only thing; it should be much wider than that. The implications of AIDS for Africa are huge and immense. We look on aghast at the problems being faced on that continent, which is being ravaged by AIDS. Anything that the Wales Centre for Health can do to help produce programmes that may spread even into Africa would be welcomed by every member of the Committee; indeed, we would be proud of its work.
 I asked about the internet and I am reassured by the Minister's answer. He said that the centre would have a website that could be accessed by all interested groups, wherever they happened to be, so long as they had access to the internet. I am grateful for that confirmation. 
 Like the Minister, we want the centre to be independent. However, we want at least some part of it to be more independent of the Assembly than it would be under the Bill, which is the reason for the amendment. It is a probing amendment to allow us to press the Government on whether there are any means of ensuring that the centre is independent of the Assembly. Although the Minister assured us that the Nolan committee appointments procedure would be followed, that may change. It is not included in the Bill; I cannot see the word ''Nolan'' there. What 
 assurances do we have that that procedure will always be followed? We in Parliament are placing a huge amount of trust in the Welsh Assembly and its Executive.

Don Touhig: I accept and value the hon. Gentleman's comments. I should have stressed earlier that the Assembly has agreed a code of practice for recruitment to all such organisations. That can be changed only by a majority vote in the Assembly. I hope that he will accept that reassurance, because it would require all-party support to make such a change.

Nigel Evans: I am grateful to the Minister. I know how much more difficult it is for any one party to have overall control of the Welsh Assembly. Even if a party wished to go down that route, I hope that there would always be an element of independence that would resist such a move. We want the Wales Centre for Health to be manned by people who are appointed for their expertise and experience, as it will be dealing with many wide-ranging areas of health promotion in Wales. However, I am sure that he will not blame us if we look for worst-case scenarios and ways of ensuring that the Bill is as watertight as we can make it. The Minister has given us certain assurances. The suggestions that we have made may be reconsidered in the other place, but I beg to ask leave to withdraw the amendment.
 Amendment, by leave, withdrawn. 
 Clause 2 ordered to stand part of the Bill.

Schedule 2 - Wales centre for health: further provision

Bill Wiggin: I beg to move amendment No. 18, in
schedule 2, page 8, leave out lines 27 to 32.
 This is very much a probing amendment. At first glance, paragraphs 6 and 7 of the schedule seem reasonable. Paragraph 6 states: 
''If it appears to the Assembly that there has been a serious failure by the Centre to perform any function which it considers should have been performed by the Centre, the Assembly may give the Centre such directions as it may consider appropriate for remedying that failure.''
 That seems innocent enough. Paragraph 7 states: 
''Directions under paragraph 6 must include a statement summarising the reasons for giving them.''
 The Minister pointed out a few moments ago that the Wales Centre for Health was not to be regarded as a servant of the Assembly or, indeed, the Crown, yet almost everything about the centre is decided upon by the Assembly. Therefore, this is either a belt-and-braces provision, or unnecessary. 
 Paragraph 9 states: 
''The Centre must comply with any direction given by the Assembly under this Schedule.''
 If the Wales Centre for Health is responsible for any type of failure, it will automatically be in default, so paragraphs 6 and 7 are almost completely unnecessary, and the amendment would leave them out of the Bill. If the provisions stay, they will not be to the detriment of the centre, but part of our duty as a 
 Committee is to ensure that the Bill is as clear and positive as possible.

Chris Grayling: My hon. Friend is a member of the Select Committee on Welsh Affairs. Am I right in saying that the Committee expressed concerns about this whole block of legislation, particularly the apparently draconian powers that it offers the Assembly over the workings of the Wales Centre for Health? If so, will he enlighten us about the discussion that took place and whether he shares that view?

Bill Wiggin: I do, and I am grateful to my hon. Friend for bringing that up. I have a quote from Jane Hutt, who says:
''I am not being prescriptive, but I am saying we need to use regulations not to tie down the Wales Centre for Health, but at least provide the appropriate routes into the Wales Centre for Health and provide more clarity on the routes into the Wales Centre for Health.''
 We are trying to clarify the amount of influence that the Welsh Assembly should have over the centre, and whether this aspect of the Bill would allow the centre to be a scapegoat should something go wrong. Removing paragraphs 6 and 7 would tidy up the Bill, so I am curious to hear why the Minister feels it is so important to leave them in.

Don Touhig: The amendment would remove the provision that enables the Assembly to give directions to the Wales Centre for Health to remedy a serious failure in the centre's performance. That provision is essential for the Assembly to maintain proper oversight of the centre's work. Surely it would be wrong if the Assembly had no powers to intervene if it were aware of major financial mismanagement or administrative malpractice in the centre.

Bill Wiggin: Paragraph 9 says:
''The Centre must comply with any direction given by the Assembly under this Schedule.''
 Everything that the Minister has said would still apply if paragraphs 6 and 7 were removed.

Don Touhig: I am sure that if I say a few more words about the matter, what I am trying to get at might become clear to the hon. Gentleman. As I said, we want to ensure the independence of the centre. However, we also took account of the concerns that the Select Committee on Welsh Affairs—of which he is a member—expressed at the pre-legislative scrutiny stage. The hon. Member for Epsom and Ewell helpfully reminded the hon. Gentleman of what that Committee said.
 I remind hon. Members that when the draft schedule 2 was first published and put out for scrutiny, under ''Assembly directions'', we said: 
''In exercising any function, the Centre must comply with any direction given by the Assembly for Wales.''
 We have taken account of the concerns that were expressed during pre-legislative scrutiny, and the Bill has been amended accordingly. Now, the Assembly will be able to intervene only when there is a serious failure, and it must give reasons for doing so under 
 paragraph 7. We believe that that is not only a proper and adequate safeguard against any misuse of power by the Assembly or interference with the centre's work, but a backstop. If there is serious financial or other malpractice, a body must be able to intervene in order to take corrective action. That body is the National Assembly. 
 Recognising that the amendment is a probing amendment, I hope that the hon. Member for Leominster (Mr. Wiggin) is reassured. We have listened to the comments made during pre-legislative scrutiny. We have removed the all-embracing power to exercise in any function and in any direction. We have made the provisions more specific in relation to the matters that I articulated. I hope that for those reasons the hon. Gentleman will feel able to withdraw his amendment.

Bill Wiggin: I would most like to withdraw the amendment. It is unfortunate, however, that the Minister has not yet managed to convince me that everything that he said is different from paragraph 9. That is the sticking point. Under paragraph 9,
''The Centre must comply with any direction given by the Assembly under this Schedule.''
 That means that paragraphs 6 and 7 are redundant. I do not understand why such negative provisions are necessary. However, I will happily listen to the Minister again, if he will help me on that point.

Don Touhig: If I may help the hon. Gentleman, paragraph 9 relates to the directions as concerns paragraphs 6 and 7, which are specific to any failure by Assembly in the functions that I have illustrated.

Bill Wiggin: I am grateful, and I beg to ask leave to withdraw the amendment.
 Amendment, by leave, withdrawn. 
 Schedule 2 agreed to.

Clause 3 - Functions of the Centre

Chris Grayling: I beg to move amendment No. 3, in
clause 3, page 2, line 24, at end insert— 
 'Provided that it shall be obliged to coordinate those activities with those carried out by similar bodies elsewhere in the United Kingdom.'.
 I view the amendment and the principles in it as perhaps the most important for the Bill. It seeks to enshrine in the Bill a duty of co-operation across borders in the United Kingdom. It is designed to be commonsensical and constructive, and in no way to remove rights and powers from the Wales Centre for Health, but to ensure that it works in partnership, for the good of the United Kingdom, rather than in isolation from the United Kingdom. I say that with genuine passion because, despite all the processes of devolution that have taken place, we are one nation. In all parts of our country, we share issues, in particular health issues. I simply do not believe that there is one single health issue that applies to Wales alone; certainly not the issues that, one could argue, have a significant impact in the Welsh community. 
 The hon. Member for Vale of Glamorgan (Mr. Smith) intervened on me on Second Reading to refer to his proper concerns about deep vein thrombosis and about the experience of that unfortunate condition in Wales. As I pointed out to him, however, it is not an exclusively Welsh issue. Wales is undoubtedly affected by other issues. Former coalminers face problems after many years in the pits, but so do former coalminers in other parts of the country. The young generation faces health and well-being issues, but those, too, are shared by other parts of the country. 
 We do not have a Welsh health service or an English health service; we have a national health service, as is right and proper. It is right that we make the best use of the resources available to us as a nation and that we do not commit resources unnecessarily to duplicating effort. At the same time, we must recognise that the localisation of health education and of some aspects of research may meet some local community needs. 
 It is fundamentally important that the Bill enshrines a spirit of co-operation, without detracting from the Welshness of certain services. As I told the hon. Member for Monmouth in the previous debate, health issues cross boundaries.

Hywel Williams: Is the hon. Gentleman aware of the condition that affects slate workers and ex-slate workers in my constituency? It is probably unique to north Wales, as is the fact that the employers went bankrupt. In 1979, that led to the passing of legislation that applied only to those slate workers and nowhere else in the UK, as far as I know. I do not see how there could be co-operation, as the hon. Gentleman called it, with parts of the UK where a condition does not exist and where employers have not gone out of business.

Chris Grayling: If there is an individual case, I stand to be corrected. I should remind the hon. Gentleman, however, that there has been an established slate mining industry in other parts of the country; most notably in the peak district. It would surprise me, therefore, if his constituents' experience was limited wholly and exclusively to his part of Wales. It may have suffered more than any other part of the UK, and different areas will always be affected differently. However, I should be astonished if any complaint was wholly and exclusively limited to Wales, even though some complaints are more significant there. I fully accept the hon. Gentleman's point about his constituency experience, but when he hears the full details of my argument, he will see that that one case does not prove that I am wrong.
 Health services cross borders. I mentioned that the Association of Welsh Community Health Councils had embarked on a project to assess the level of service provided by English health organisations to Welsh patients in the cross-border region. In the areas around Chester and, indeed, right the way up the border, there will inevitably be crossovers involving people who live in Wales and the English health service, as well as people who live in England and the Welsh health service. Several years ago, a significant issue arose right on the border, in the constituency of my hon. Friend the Member for Leominster, where a 
 hospital closure had undoubted implications for both communities.

Jon Owen Jones: I have just thought of a crossover problem, and the hon. Gentleman might like to think about whether the amendment would deal it. If, as reported, the Welsh Assembly does not enact the Bill's provisions on bed blocking, but they are enacted in England, English hospitals will presumably be entitled to charge Welsh local authorities for bed blocking, while Welsh hospitals will not be able to charge English local authorities. Would the amendment sort that interesting problem out?

Chris Grayling: The hon. Gentleman makes an interesting point, although I do not think that my amendment would solve the specific issue. None the less, it is a good point. As funding regimes differ between local authorities, and, potentially, between England and Wales, the whole issue of placements for the elderly in care homes will open up a Pandora's box of problems for the care home sector and for local authorities, such as placing people across the border for financial reasons.

Nigel Evans: Perhaps the Wales Centre for Health will look into that, to work out what will happen to elderly people in certain areas who are bed blocking. The hon. Member for Cardiff, Central (Mr. Jones) raises an interesting point. If fines are introduced in England but not in Wales, bed blocking may be eradicated in England but not in Wales. That should interest both the Wales Centre for Health and community health councils.

Chris Grayling: I thank my hon. Friend for that salient point. My amendment is designed to focus primarily on two areas; medical and health research, and the provision of public information and education on health. I strongly believe that we need to ensure that there is proper collaboration and co-ordination in those two areas. Medical research already crosses boundaries. I have looked to see what research is currently being conducted, and it is obvious that the medical research that is taking place in Wales—either research generated from within Wales or research programmes to which people in Wales are contributing—is international. For example Cancer Research UK has been funding a project involving girls in Wales, England and three other European countries, to investigate links between health issues for girls before puberty and cancer. That is an example of a health problem that crosses many boundaries and a research project that is being carried out in several countries; people are pooling information and working collaboratively for the benefit of everyone in those countries.
 Some excellent medical research is taking place in Wales, for example on cancer. The cancer charity Tenovus, based in Wales, is doing excellent work, both in the Principality and internationally, looking for new treatments to combat cancer. Its research is based on work carried out in Wales but it is used in an international arena. The charity is working across the United Kingdom, and has people working in Cardiff, as well as at its research centres in Southampton, Liverpool and Bournemouth. That UK team is doing a first-rate job, developing new 
 projects to tackle different sorts of cancer. Their work should be applauded. 
 Among the international community, the UK remains at the leading edge of medical research. We need to use our strengths to benefit everyone, because the health solutions that we discover will provide better outcomes for patients around the world. That is why we must not be provincial in our approach to health research. 
 Under the legislation, the Wales Centre for Health has a particular remit, to 
''undertake and commission research into such matters''.
 I appreciate that much of that research may be at a low level or local, but equally it could be at a high level or relate to public health or specific issues of concern. It would, therefore, be a dereliction of duty on the part of that organisation and the health service in Wales if research were simply undertaken in a Welsh context, without examining whether there were similar issues elsewhere in the United Kingdom, without exploring whether similar projects were being considered by bodies elsewhere in the UK and without a degree of partnership between the Wales Centre for Health and its counterparts elsewhere in the UK. That is plain common sense, making the best use of resources in the NHS. 
 The amendment is designed only to write a duty of care into the Bill and to send a message from the UK Parliament—ultimately responsible for our national health service—that the different component parts of our nation should work together. Where they face common issues, they should make the best use of available resources, pool their expertise and share their best practice. I hope that the Minister will accept that the amendment would enhance the role of the Wales Centre for Health, without detracting from its powers. It would underline the fact that the centre operates within a United Kingdom health framework, of which it should be mindful in undertaking its work. 
 On public information and education, consistency of message is important. We face several significant health issues. My hon. Friend the Member for Ribble Valley referred to the alarming growth over the past 12 months in the number of people found to be HIV positive. I fear that, as a nation, we have become too complacent about the threat of AIDS. 
 Fifteen years ago, public information campaigns warned people of all ages, but particularly the young, about the risk of AIDS and the different ways of contracting it. Advice was given about the steps necessary to remain infection-free. The campaign was largely successful. The doom-mongers in this country, who said that AIDS would swamp us within a few years were proved wrong. We have not been swamped; we have remained relatively immune, though it remains tragic for the small minority who are infected. 
 As we look abroad, we recognise that the threat is far from gone. In parts of the world, AIDS remains a scourge on humanity, perhaps the greatest threat that 
 humanity faces. Africa has infection rates of 30 to 40 per cent., and both India and China face mounting infection rates. We must recognise how vulnerable we are as a nation to HIV/AIDS, in a world where people travel and cross borders legally and illegally. It is crucial to pick up on the work of 15 years ago and make a new generation of young people aware of the threat of HIV/AIDS. It is just one example of many where our society has a duty to educate people about the health threats that they face, the lifestyle choices that they make and their implications for their future health. 
 Let us examine the practicalities. When AIDS campaigns were waged in the 1980s, extensive use was made—quite rightly, as it is the most effective means of reaching our population—of television. However, let us reflect on the implications of ITV companies, for example. HTV, viewed in many parts of the west of England, is not an exclusively Welsh organisation; Granada, covering areas beyond Chester and extending into north Wales, is not an exclusively English organisation. BBC programmes have the same problem, as do local radio stations and newspapers. The media does not stop at the boundaries of England and Wales. People in England will hear messages sent out by the Wales Centre for Health and the population of Wales will hear messages sent out by public health bodies in England. Without co-operation and partnership between the bodies, we will be sending conflicting messages to the younger generation over matters such as HIV/AIDS at a time when we simply cannot afford to do so.

Jon Owen Jones: Conflicting messages can be a benefit because no one has a monopoly on truth and wisdom. For example, when the BSE crisis arose, there was a monopolistic view that eating beef was perfectly safe. However, the then medical adviser in the Wales Office, under a Tory Government, took the opposite view. It turned out that she was correct. Had there been a separate body, both views would have been put into the arena, to the public benefit.

Chris Grayling: There will always be multiple opinions in the medical and scientific communities. New research comes out one week and we are told that we can eat something. The following week there is another piece of research and we are told not to eat it, only to be advised the week after that that the food is very healthy. One loses touch with what is good for you and what is bad.
 Should a young person watching a public information campaign about HIV/AIDS, produced by the Wales Centre for Health and shown on HTV, receive a dramatically different message from that shown a moment or two later on Channel 4 from the public health bodies in London? Would that be prudent? That is why I believe in a partnership campaign and the co-ordination of messages.

Jon Owen Jones: The proposal would not work in that way; various pressures would be put on agencies. If I may to return to my earlier example, in the case of BSE, the pressures came from the industry not to frighten the consumers. No matter what side of the River Severn we are talking about, if it was believed that someone would publish and be damned in any
 case, people would consider the research more carefully and probably come up with a united, and therefore better, view.

Chris Grayling: The hon. Gentleman is making my case for me. It would be a nonsense if the Wales Centre for Health said that beef was safe, the Food Standards Authority in London said the opposite and public information campaigns in London and Cardiff reflected those diametrically opposite opinions. When messages are crossing borders, it should be beholden on the bodies involved to get together and work out the best message.

Hywel Williams: Will the hon. Gentleman explain what ''co-ordinate'' means? I accept that he uses the word for the purpose of argument but he suggests a situation in which the Welsh body might go in one direction and bodies elsewhere in the United Kingdom in another. On the whole, people tend to go in the same direction, with variations. Does ''co-ordinate'' mean that everyone has to be absolutely the same and hold a monolithic view of the issue or is the hon. Gentleman allowing a variation for the Celtic fringe?

Chris Grayling: The word ''co-ordinate'' means just that. Those running public health information services in the Wales Centre for Health should be in touch with their counterparts in London and know what they are doing, and vice versa. Ideally, the same should be done in Scotland although I appreciate that that is not within the remit of the Bill. We should ensure that the bodies focusing on health issues in different parts of the United Kingdom are in contact with each other and work together. Even if the nature of their campaigns is different, they should at least ensure that there are no absurd conflicts of the kind that could arise if a dialogue does not take place. That is the sole purpose of the amendment.

Roger Williams: I agree with the hon. Gentleman's argument. However, if science on a particular issue is well established and agreed, there is hardly likely to be a different approach to communicating it to the public.

Chris Grayling: One would hope that the approach would not be different. Anyone who has been involved in communication—my professional background before I came to this place—knows that organisations are wonderfully good at saying things that contradict one another. A marketing campaign from one department will say one thing, and another campaign from another department will say something diametrically opposite. The company concerned is then in a mess as a result.
 That lesson should be taken on board by the public sector, especially the national health service in this arena. It should simply be a duty of care for those responsible for research and for public information and education to ensure that they talk to each other, work together and co-ordinate their work, so that each strengthens what the other does, rather than weakens it by putting out contradictory messages. 
 The amendment would not remove any powers from the Wales Centre for Health, but would put a duty of care on it, simply to remind the centre that it is part of a health service that is spread across the United 
 Kingdom and that it will indulge in activities that cross borders. The need for co-ordination and to work together with other parts of the UK is sacrosanct and should be included in the Bill.

Hywel Williams: I asked the hon. Gentleman what ''co-ordinate'' means, as the amendment states that the centre is obliged to co-ordinate
''with . . . similar bodies elsewhere in the United Kingdom''.
 That is in terms of 
''the provision and development of training''
 as well as information on 
''protection and improvement of health''
 and the commissioning of research. My fear is that the amendment would prevent a specific Welsh view being taken of specific Welsh problems. 
 If I were in the hon. Gentleman's shoes, I would take care when using the word provincial. Some people get rather prissy about its use in terms of Wales, because we see some issues as national. 
 Perhaps ''co-ordinate'' means allowing certain variation, but would it prevent the Wales Centre for Health from taking a particular course? I recently visited the Fresno centre for ageing in California, where there is an innovative and promising project on the health of older people. It combines several features, such as a public health campaign against abuse of the elderly in co-operation with the sheriff's departments and prosecution departments. I am not aware of a similar venture in the UK. If the Wales Centre for Health wanted to do such work, would it need to co-ordinate that with something that did not exist elsewhere in the UK?

Chris Grayling: If the Wales Centre for Health were to invest in excellent research such as that, would the hon. Gentleman think it prudent of the centre to tell organisations elsewhere in the UK that it was going to do so, and to offer to share the findings with them?

Hywel Williams: The hon. Gentleman makes a good point. The centre could commission research. I do not underestimate the propensity of academics to fight and disagree, but it is a matter of good practice and pride for people who have done such research to publish their views and engender a discussion among their peers. It is entirely reasonable to expect the Wales Centre for Health to do that as part of its day-to-day business.
 The hon. Gentleman argued that there was nothing unique in terms of health in Wales, and I referred to silicosis. The relevant employers in Wales have gone out of business and, therefore, there was legislation to provide compensation, funded by the Government. I hope that he accepts that explanation.

Chris Grayling: I accept that there may be an exception to every rule, but those exceptions are not the norm; that was my point.

Hywel Williams: My concern is that ''co-ordinate'' might prevent development rather than encourage co-operation. I have in mind the patterns of Welsh health and ill health; in particular the chronic health problems arising from our industrial past, and the provision of public health information in rural areas,
 particularly in terms of the bilingual situation. I would suggest that the sort of bilingualism that we have in Wales is not replicated elsewhere.
 The hon. Gentleman referred to broadcasting organisations. I can imagine a public health campaign that was conducted in Welsh on S4C—Sianel Pedwar Cymru—having limited application over the border, but I would not like it to be prevented for that reason. The Wales Centre for Health should not be prevented from providing and developing training either. I was once involved in developing Welsh-medium training in social work. That was probably unique and of limited application; we certainly had limited success in interesting people over the border in the research. I would encourage hon. Members to resist the amendment for those reasons. The Wales Centre for Health should have the widest possible freedom of operation.

Don Touhig: The hon. Member for Epsom and Ewell has made an important contribution to the debate; he has taken it to a higher level. It is refreshing to know that he has a wide and deep interest in the health service, which is not always characteristic of members of his party.
 I hope that my remarks will reassure him that his amendment is not needed. It would place a statutory duty on the centre to co-ordinate its functions with other unspecified bodies in other parts of the United Kingdom. Organisations such as Cancer Research are not statutory bodies; they cannot be required to co-operate or co-ordinate, nor would it be possible to ensure reciprocity so far as they were concerned. The amendment would also impose a considerable unnecessary burden on the centre. It would mean an unjustified restriction on its freedom of action and its scope to address the problems of Wales. 
 The hon. Member for Caernarfon referred to the hopes and aspirations of the centre working within Wales. The Assembly sees it as its key task to help to prevent ill health in Wales, promoting health and well-being and tackling inequalities in the health service in Wales. The issues referred to by other colleagues, such as bed blocking, are matters for CHCs to scrutinise. Research and surveillance of health trends is a public health issue that would be in the orbit of the Wales Centre for Health. It is important to point out that the amendment says: 
''Provided that it shall be obliged to coordinate those activities with those carried out by similar bodies elsewhere in the United Kingdom.'.
 There are no other similar bodies; there are no bodies equivalent to the Wales Centre for Health in the rest of the United Kingdom, so it would be difficult to comply with that part of the proposal. There are many bodies in the UK that might carry out some of the functions of the centre, but there is not one equivalent that would have a duty to work in the way in which the Wales Centre for Health will do. 
 Paragraph 20 of schedule 2, which covers general powers, states: 
''The Centre may do anything which it considers necessary or expedient for the purpose of, or in connection with, the exercise of its functions.''
 and 
''That includes, in particular—co-operating with other public authorities''.
 It is built in to the legislation that the Wales Centre for Health will have the opportunity to co-operate with other public bodies. The Assembly intends that the Wales Centre will co-operate with other public bodies. It is the intention of the Assembly that the centre should co-operate with other public bodies in Wales and in other parts of the United Kingdom. Indeed, as hon. Members will know, a shadow Welsh centre for health already exists in the Velindre NHS Trust in Cardiff. That shadow body has already collaborated with the Agency for Toxic Substances and Disease Registry in the United States of America on matters relating to the landfill tip in Rhondda Cynnon Taff. Even in its embryo state, the centre has been collaborating with organisations outside Wales. 
 The centre will work in collaboration with several bodies, but it should be free to determine how best to do that without the imposition of an unnecessarily burdensome statutory requirement. I hope that the hon. Member for Epsom and Ewell is reassured that the centre will have the opportunity to collaborate and co-operate with a range of bodies throughout the country, and that he will feel able to withdraw the amendment.

Chris Grayling: I take that at face value, but I differ from what the Minister says in this respect. I accept that provision is in place to enable the centre to work with others, but my point of principle is that its work—not all, but some of its work—will have an impact beyond the Welsh borders. I fully accept the point made by the hon. Member for Caernarfon that there are some specifically Welsh issues, such as public health provision in the Welsh language and Welsh language services. I might tell him that when I lived in Cheshire, I used to watch some of the programmes on S4C in English because of the mix of languages.
 The impact of some of the work carried out by the Wales Centre for Health will be exclusively Welsh, and I do not want to prevent it from doing things in Wales for Wales. Indeed, I accept the Minister's assurances that the shadow body has already started to do that. However, it should work with organisations elsewhere, where there is a benefit in doing so. My concern is that its work will have an impact on other parts of the United Kingdom. It could generate work that is duplicated elsewhere or it may be able to contribute to work taking place in other parts of the UK. 
 The hon. Member for Caernarfon mentioned rural areas and the industrial past of Wales. I fully accept that those issues exist, but I would argue that they exist in other parts of the country, such as Cornwall, the north-west, the north-east, Yorkshire, and the black country. In some of the more rural parts of the UK, such as the lake district and the west country, there are common issues reflecting rural issues and industrial heritage. The border issue causes me most concern, however. If the Wales Centre for Health adopts a role in public information provision and education, the 
 messages it sends out will inevitably cross borders and be heard in England, as well as in Wales. There is no wall between the two countries; we mix and match across borders. 
 The word ''co-ordinate'' was chosen carefully because it does not imply that something must be done or not done. It simply requires discussion to take place to ensure that work is co-ordinated, is not duplicated and does not unnecessarily contradict work carried out by similar bodies. I do not accept that those similar bodies include cancer research charities, but rather public bodies with a remit in the same field of public health information, medical and health research and training. I am happy to listen to suggestions from the Minister about how to draft the amendment differently. I would be happy if the Minister took away the principle and offered to return, on Report or in another place, with an alternative suggestion for including in the Bill a strong signpost to the Wales Centre for Health to that effect. 
 The principle, which is in the interests of the United Kingdom health service, is that the Wales Centre for Health should be free to do what it needs for Wales, while being mindful that what it does may have an impact in other parts of the country. There may be issues on which it should work with its counterparts, or with organisations that have some of its functions, in other areas of the country. 
 No one would lose by the Government accepting the amendment. Indeed, the UK—and health provision throughout the UK—stands to gain by it. I wish to press the amendment. I hope that I have persuaded the Minister to accept the principle of the amendment in its own right. If not, I hope that he will go away and consider the issue and return with a proposition that would encompass my general point in the Bill in a way that he can live with.

Don Touhig: I accept that ill health knows no boundaries. Miners in my local valleys are suffering just as badly as the boys in Durham and Scotland as a result of the problems in the pits. However, good health practice knows no boundaries either. In Wales, we have set the pace on some good health practice, but we can also learn many things from other parts of the UK.
 I accept the hon. Gentleman's argument; we should not have artificial, albeit historical, boundaries between us on health care. However, the reports of the Wales Centre for Health will be posted on its website; its work will become known. Under schedule 2(20), there is an opportunity for collaboration with other bodies throughout the UK. 
 I strongly resist placing in the Bill a requirement that says ''You must'' to the Wales centre for health. The amendment states that the centre 
''shall be obliged to coordinate those activities with those carried out by similar bodies elsewhere in the United Kingdom.''
 It does not say that the centre may or can do that. I am resisting a heavy-handed approach, because I do not wish to place unnecessary burdens on the new centre when all the opportunities are there for collaboration and sharing best practice. 
 I urge the hon. Gentleman to reconsider and to accept that the opportunity to do as he wishes exists under the Bill. We are not prepared to place the obligation that he proposes on the centre, because that would be unnecessary. As I said, all the opportunities are there for the centre to collaborate with bodies throughout the whole of the UK.

Chris Grayling: I have listened carefully to the Minister's arguments and I do not wish to detain the Committee by pressing the amendment to a vote now. However, I will consider what might be done on this front at a later stage, because I feel strongly that the amendment would do nothing but strengthen the provision of health care throughout the country, and would in no way detract from what the Minister rightly wants the centre to be able to do. For now, I beg to ask leave to withdraw the amendment.
 Amendment, by leave, withdrawn.

Chris Grayling: I beg to move amendment No. 9, in
clause 3, page 2, line 35, leave out subsection (4).

Win Griffiths: With this we may discuss the following amendments: No. 10, in
clause 3, page 2, line 37, leave out subsection (5).
 No. 11, in 
clause 3, page 3, line 1, leave out subsection (6).

Chris Grayling: These are more probing amendments. They are designed to elicit from the Minister what he anticipates being able to do under the powers, because in theory they are quite draconian and quite disruptive. We are establishing the Wales Centre for Health through primary legislation, but we are devolving to the Assembly the power to get rid of it, which seems contradictory. I should welcome clarification from the Minister, because I understand that primary legislative responsibility for the health service in Wales remains with this House. It seems odd to say the least that we are debating this issue here, but are willing to give the Assembly carte blanche to abolish the entity that we are legislating into place.
 It is important to understand the potential use of the powers. These not only allow the Assembly to take the decision to abolish the body, but give the Assembly the power to emasculate it. We need to understand precisely why that is necessary and what safeguards exist to protect the centre against, for example, a new empire-building Minister who wanted to create a more substantial Department with greater control over what happened to health care in Wales. 
 We were particularly concerned about subsection (4), which states: 
''The Assembly may by order make provision for the transfer to it of any or all of the Centre's functions.''
 In what circumstances does the Minister expect that power to be used? What would be the implications for the Wales Centre for Health? What financial compensation would be made to the centre? Making a transfer of that kind would reduce the scale of the centre without necessarily reducing its core overheads. It is theoretically possible that removing a key department could undermine the centre's viability and cause financial problems. What safeguards does the Minister envisage being put in place to prevent the 
 centre being undermined, perhaps by an Assembly keen, in particular circumstances, to put a department under the control of the Welsh Department responsible. 
 What are the implications for staffing? We are talking about the wholesale transfer not only of property but of employees. Are we saying that the Assembly has the power to transfer people on a whim? Would that have implications for the independence of the body? A variety of matters could arise as a result of the use of such powers. Indeed, in considering the purpose of the provisions, my hon. Friends and I have considered various scenarios in which we could imagine that happening. For instance, if a foot and mouth outbreak were to occur—God forbid—the Assembly might choose to bring together a team of people from a number of organisations to combat it. That might be a proper and sensible thing to do, but it could undermine the viability of the centre. It would make it much more difficult for the rest of the centre to do its job by pulling out people and core resources; perhaps even putting a building under the separate control of a different body or department. 
 In what circumstances does the Minister envisage those powers being used? What would the issues be? How would those powers apply to staff? Will staff be employed by the centre, or will they remain effectively as Welsh civil servants? What powers would the board of the Wales Centre for Health have to challenge decisions with which it disagreed? Can he reassure us that those measures would not allow short-term political expediency to take over from good practice? The loss of functions would frankly make it much more difficult for the centre to continue functioning. 
 The amendments are probing, but we need to know precisely how the Minister sees those powers being used and what their purpose is.

Don Touhig: I will try to help the hon. Gentleman, and clarify the circumstances that might require the Wales Centre for Health to be wound up. The provision recognises that in future the Assembly may want to make changes to the functions of the centre, or even abolish it in favour of other arrangements. I stress—I even underline it—that there are no plans to abolish the centre; the provision is included merely so that proper arrangements can be made should the centre be wound up.
 It is important that we should give the Assembly the ability to meet future contingencies. For instance, it might consider that some or all of the functions of the centre would be more appropriately undertaken by another organisation; its training functions might be undertaken by a training organisation, for example. It might be necessary to wind up the centre and arrange for certain functions to be carried out by the Assembly itself, as the body responsible for delivering the health service in Wales, or by bodies within its control. 
 The provision is designed to enable the Assembly to respond to future developments in public health in Wales. Many changes have occurred over the years and we will need to respond to further changes, as required. 
 The proposal for the Wales Centre for Health was part of a package of changes set out in ''Better Health, Better Wales''. Next year, other public health functions in Wales will be reorganised, with health authorities abolished and a new public health service created. We have seen evolving management structures within the health service over recent years and it is appropriate to make provision in the Bill ''in case''. It is right for the Assembly to review working arrangements and make necessary adjustments; it will need the powers to do so. 
 Amendment No. 10 is linked with amendment No. 9. The Assembly should have discretion over how it organises the public health function in Wales. In future, as I said, the Assembly might want to abolish the Wales Centre for Health, in favour of other arrangements in support of that function. I cannot speculate about what the exact arrangements might be; that is for the Assembly to decide, but I repeat that we have no plans to abolish the Wales Centre for Health. The possibility is there, should circumstances change. It is part of the Assembly's devolved function to be able to determine organisational arrangements for itself in accordance with its own priorities. 
 As for amendment No. 11, the Assembly must be able to make provision for dealing with the centre's staff, assets and liabilities in the event of an order transferring its functions under clause 4. The Assembly might in future want to change the centre's functions in order to achieve greater effectiveness or efficiency. We must recognise that, although we have no plans whatever to abolish the Wales Centre for Health, it is appropriate to make provision in case the Assembly wants to revisit its functions and re-examine its work. Under the Bill, the Assembly will be able to take appropriate action without the need for further primary legislation.

Chris Grayling: It is strange that we are establishing a body through primary legislation, while passing to the Assembly the power to abolish it. I am doubtful whether that is consistent with a national health service. We properly devolve powers within the NHS to Wales, but we should retain national health service frameworks, so I am unconvinced of the need for abolition powers. However, I am happy with the Minister's explanations and reassurances on other matters, so I beg to ask leave to withdraw the amendment.
 Amendment, by leave, withdrawn. 
 Clause 3 ordered to stand part of the Bill. 
 Further consideration adjourned.—[Mr. Ainger.] 
 Adjourned accordingly at twenty-two minutes to Seven o'clock till Thursday 12 December at five minutes to Nine o'clock.